Kathy Matheson, Psychologist and Founder of Karepsych
This is a guest post on the Coviu Blog:
My name is Jocelyn and I’m an imposter. This is seriously how I felt when I started my ‘Telecoaching for doctors’ business. Setting aside the fact that I was trying to start a new concept that I didn’t know would take off, I had a million other questions and doubts running through my mind.
Self-doubts that sounded like: Who am I to be running a Telecoaching business? Who am I to be asking people to discuss important issues with me over the Internet? And pay me? Come to think of it, how will I get paid and manage invoicing at a distance? What about the security of the call? The connections? And how will I keep records and manage consent? How will I market this business – maybe no-one will come – after all, although I’m a doctor, I’m not a specialist psychiatrist or GP. I’m just someone with a passion for coaching and spent the last 5 years studying, practising and working in the field.
What cured me of this, really, was just getting started and doing it anyway. Making many mistakes along the way. Building networks, asking for help, trying different products. I still haven’t got everything running as smoothly as I’d like and I don’t claim to have all the answers. It’s been a bit of a rocky journey. Connections still drop out for reasons out of my control, mostly related to the evolving networks in Australia. I still accidentally double book myself because I can’t get my different calendars to consistently talk to each other. But with a website, blog, facebook page, client management system, record system, booking system and billing system to set up and maintain (oh as well as actually doing the coaching) I don’t think I’m doing too badly. Actually, considering I have figured out most of this by learning as I go, I think it’s actually fantastic. Yay me.
My self-doubt started to slowly change as doctors started contacting me for help and returning for repeat sessions and telling me about how much better things were going for them. So my coaching seemed to be working – and the systems I had in place were working. Not perfect or ideal – but adequate. It’s still embarrassing when the connection drops out – I, like most humans, break into a flustered sweat when that happens. But I'm starting to find ways to deal with it.
Anyway, what really helped the most, was seeing for myself that I was totally not alone as feeling like an imposter. It’s a little like an AA meeting. Many (probably most) of the doctors I coach tell me (or rather confess) that they feel like an imposter. Even the ones who look, on the outside to be super-successful. Doctors were telling me that despite all their awards, accolades etc they don’t feel competent and ‘maybe just a little more study’. You can practically hear the ‘I’m going to get found out one day’ hanging in the air.
You can also sense the potential opportunities not taken. I mean why bother applying for a job, or starting a new business or venturing into Telehealth if you think you don’t have what it takes?
But it doesn’t have to be that way. Imposter syndrome is something you can work on and change – even grow from. I know, because I’ve done it. And now spend a lot of time teaching other people how to do it too.
So just what is imposter syndrome anyway?
Imposter syndrome is an inaccurate and negative self-assessment about your own competence or ability that persists despite external evidence to the contrary. Some people (more commonly women) develop a belief about their perceived incompetence and don’t internalise a feeling of success despite a string of achievements. Degrees, qualifications, awards just aren’t enough to counter the belief about not being good enough or that you got to where you were by some grand mistake and that soon enough you will be found out. .
Imposter syndrome can (and does) affect doctors at all career stages – even outstanding performers can harbour a secret belief of incompetence . Although imposter syndrome is by no means universal, nevertheless, many people are vulnerable to this for a range of reasons - partly personality, partly our expectations of perfection (and the knowledge that no matter how hard we work the gap between our current ability and perfection can never narrow), partly because of the focus on the negative in our workplaces and in medicine as a whole (which by the way is a useful skill for diagnostics).
It's probably inevitable that everyone incorrectly estimates their ability and competence - because it's just not possible to have a 100% accurate view of ourselves. We just have too many blind spots. This becomes a problem when it results in distress and hampers career development.
So how can you conquer the imposter inside?
There are a number of strategies that I use myself and teach which I have found useful, all which really hinge around developing a growth mindset . Some of these include (in no particular order):
- Recognising that you have blind spots and incomplete knowledge about yourself
- Letting go of judgement and refraining put a value label on ourselves or anyone else for that matter.
- Embracing curiosity about other perspectives and different ways of seeing.
- Learning more accurately about yourself through a process of reflection and soul-searching – but ensure this is done in a curious and solution-focused way. Unsupported, or non-strategic, reflection can rebound and end up making you feel worse.
- Taking on board feedback from others. It’s probably safe to say that positive feedback is rare in medicine, so if you get some – take it seriously. People don’t praise unless they mean it.
- Stop focusing so much on how good you are and start focusing on what needs to be done – whether that is treating a patient, setting up a business, or engaging in something new – like telehealth.
- Accept yourself as a learner – and ask yourself each day what you are going to learn. This almost forces a curious and learning mindset.
- Take a really good look at what you do well and what goes well – and acknowledge in a fair way the effort you have put in.
- Embrace failure – seriously. I don’t mean stop caring and trying to do our best. I don’t mean engaging in unsafe practice. But what I do mean is that despite our best efforts things might not turn out how we hoped. That MIGHT be due to a flaw in ourselves – but it also might be a flaw in the environment or a feature of complexity and unpredictability. It’s not always clear – BUT there is always an opportunity for learning.
- Embrace your vulnerability. And in Telehealth this is pretty important as we are so dependent on the internet actually working.
This all sounds simple on paper – but it can be difficult to do alone as really this is about changing deeply ingrained habits – and making incremental changes. So, give it a go – but be prepared to involve others.
Sharing challenges in conversation with a friend, colleague, mentor, counsellor, coach or therapist can really help. I did not do all this alone – I have had my own coaching and discuss many of these issues with my supervisor who is a clinical psychologist.
By Dr Jocelyn Lowinger - Owner, Coach GP www.coachgp.com.au and Coviu user
Want to know more?
You might enjoy listening to a podcast I made with Black Dog Institute on imposter syndrome in the medical profession.
Otherwise, happy to answer any questions about this - feel free to contact me firstname.lastname@example.org
- Clance, P.R. and S.A. Imes,The imposter phenomenon in high achieving women: Dynamics and therapeutic intervention. Psychotherapy: Theory, Research & Practice, 1978. 15: p. 241.
- LaDonna, K.A., S. Ginsburg, and C. Watling,“Rising to the Level of Your Incompetence”: What Physicians’ Self-Assessment of Their Performance Reveals About the Imposter Syndrome in Medicine. Academic Medicine, 2018. 93(5): p. 763-768.
- Dweck, C.S.,Mindset: the new psychology of success. 1st ed. 2006, New York: Random House.